WO2010034496A1 - Jeu de pièces pour la construction d'une prothèse de disque intervertébral et système de construction de différentes prothèses de disques intervertébraux - Google Patents

Jeu de pièces pour la construction d'une prothèse de disque intervertébral et système de construction de différentes prothèses de disques intervertébraux Download PDF

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Publication number
WO2010034496A1
WO2010034496A1 PCT/EP2009/006906 EP2009006906W WO2010034496A1 WO 2010034496 A1 WO2010034496 A1 WO 2010034496A1 EP 2009006906 W EP2009006906 W EP 2009006906W WO 2010034496 A1 WO2010034496 A1 WO 2010034496A1
Authority
WO
WIPO (PCT)
Prior art keywords
prosthesis
plates
rotation
prosthesis plates
kit according
Prior art date
Application number
PCT/EP2009/006906
Other languages
German (de)
English (en)
Inventor
Franz Copf
Original Assignee
Franz Copf
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Franz Copf filed Critical Franz Copf
Priority to EP09740261.4A priority Critical patent/EP2339993B1/fr
Priority to US13/120,584 priority patent/US20110257747A1/en
Priority to CN2009801454831A priority patent/CN102215786A/zh
Publication of WO2010034496A1 publication Critical patent/WO2010034496A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30365—Rotation about the common longitudinal axis with additional means for limiting said rotation
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
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    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30462—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
    • A—HUMAN NECESSITIES
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • A—HUMAN NECESSITIES
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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    • A—HUMAN NECESSITIES
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

Definitions

  • the invention relates to a kit for the construction of an intervertebral disc prosthesis, which is intended to be arranged in a vertebral body limited intervertebral disc space.
  • the invention further relates to a system for constructing differently configured such disc prostheses.
  • Intervertebral disc prostheses are implanted in the event of intervertebral disc damage, in which replacement of the damaged intervertebral disc is necessary.
  • the intervertebral disc prosthesis is inserted into an intervertebral disc space of the spinal column which is delimited by two adjacently arranged vertebral bodies.
  • Intervertebral disc prostheses are intended to ensure the least possible impairment of the mobility of the patient and are often designed as articulated prosthesis plates.
  • the configurations differ eg with regard to the size of the prosthesis plates, the distance between the prosthesis plates and the position of the movement center, ie the point of rotation about which the prosthesis plates can be pivoted relative to each other.
  • Intervertebral disc prosthesis Intermediate elements which can be designed as joint elements or swivel angle limiters.
  • receiving shafts are provided in the prosthesis plates, which are designed to receive the intermediate elements.
  • a pivot bearing of the known disc prosthesis is designed as a ball joint and has three rotational degrees of freedom of movement in the implanted state in the disc space.
  • the movement properties of the smallest functional unit of the spinal column originally formed from the opposite vertebral bodies and the intervertebral disc, which is also referred to as the Jungian motion segment or functional spinal unit (FSU), should be reproduced at least to a large extent by the intervertebral disc prosthesis.
  • the intervertebral disc prosthesis is like the original disc forward diffraction, which is also referred to as flexion, a backward extension, which is also called an extension, a lateral inclination to the right or left, which also as lateral flexion and a rotational movement, which is essentially to an axis of rotation extending along the spine takes place and which is also referred to as rotation.
  • the natural disc which consists of an outer, elastic connective tissue ring and a soft core enclosed by it, serves as an elastic joint and damping element and is deformed during the relative movements of the vertebral bodies. Due to their structure, the disc has in addition to the function as a joint element and a function as a deflection limit for the relative movements of the vertebral body. From the already mentioned WO 2007/003438 A2 it is known to arrange on opposite prosthesis plates exchangeable attacks that allow limiting the pivotal movement of the prosthesis plates at a lateral inclination (Lateralflexion) to the right or left.
  • US 2008/0221693 A1 discloses a disc prosthesis in which the joint elements forming a ball joint are formed integrally on the prosthesis plates.
  • Supernatants which are formed on a prosthesis plate in the region of a spherical cap, engage in recesses which are formed in the other prosthesis plate in the region of a hollow spherical shell which is complementary to the spherical cap.
  • the projections form with the recesses limiting means, which serves to limit a rotational movement about an axis of rotation aligned substantially normal to the outer surfaces of the prosthesis plates.
  • the permitted maximum angle of rotation can not be changed in this known disc prosthesis.
  • a disc prosthesis which has an elastic, generally cup-shaped body whose wall is provided with a helical circumferential slot.
  • a first joint element is fixed, which forms a ball joint with a second joint element.
  • the second joint element is in turn attached peripherally above the inner edge of the cup-shaped body.
  • a relative rotation of the joint elements about an axis extending perpendicular to the bottom of the pot is the one with the Gelenkelemen- - -
  • the object of the invention is to provide a kit for the construction of a disc prosthesis, with which the maximum allowable rotation angle can be set, regardless of the configuration of the prosthesis plates whose dimensioning should ideally be made dependent on many different factors.
  • a limiting device associated with the rotary bearing for limiting a rotational movement about an axis of rotation aligned substantially normal to the outer surfaces of the prosthesis plates, wherein the limiting device can be connected to the prosthesis plates.
  • the inventor has recognized that only if the limiting device for limiting the rotational movement as an independent, connectable to the prosthesis plates component - -
  • the maximum allowable rotation angle can be set independently of the formation of the prosthesis plates. In this way, the number of components to be kept considerably reduced, if you want to provide intervertebral disc prostheses that allow different maximum rotation angle, but may also have differently configured prosthesis plates. If, for example, a selection from four different maximum angles of rotation and four different geometries for prosthesis plates is to be possible, then it is sufficient according to the invention to provide four different limiting devices and four different sets of prosthesis plates. On the other hand, in the prior art where the rotation angle limiter is always an integral part of the prosthesis plates, a total of 16 different sets of such parts must be provided to obtain the same choices. This considerably increases the costs for the provision and disinfection of the prostheses.
  • the outer surfaces of the prosthesis plates lie substantially flat against the mutually facing surfaces of adjacent vertebral bodies.
  • the surfaces of the vertebral bodies are aligned in a neutral position of the spine substantially parallel to each other.
  • the surfaces of the vertebral bodies are normal to a portion of a spine curved S-shaped when viewed from the side of the spine, and substantially central axis of the spine when the spine is viewed backward. Neighboring vertebral bodies are in a rotational movement of the
  • a system for constructing different disc prostheses which comprises:
  • a set of limiting devices associated with the pivot bearing for limiting a rotational movement of the prosthesis plates about an axis of rotation aligned substantially normal to the outer surfaces of the prosthesis plates, the limiting means of the set differing at least in that they limit the rotational movement to different maximum angles of rotation, and wherein the Begrenzseinrich- lines with different prosthesis plates are connectable.
  • the limiting device is detachably connectable to the prosthesis plates.
  • this has the advantage that a limiting device which is inadvertently connected to the prosthesis plates does not mean that the assembly resulting therefrom can no longer be used at least for the relevant patient.
  • a releasable connection also makes it possible to replace it with another limiting device, even after the implantation of the intervertebral disc prosthesis in the intervertebral disc space.
  • the limiting device or a part thereof is connected to a push-in element, which can be inserted into a receiving shaft, which is formed in one of the prosthesis plates.
  • the receiving shaft can be adapted to the insertion element such that the insertion element can be introduced into the receiving shaft only along one direction.
  • the limiting device comprises at least one flexible connecting element extending between the prosthesis plates, with which the rotational movement about the axis of rotation can be limited without the involvement of stops.
  • the flexible connecting element is preferably arranged tension-free in a neutral position of the prosthesis plates.
  • the connecting element is preferably formed elastically.
  • the connecting element can be formed, for example, from a woven, knitted, knitted or braided fabric in which fibers made of a material having low elasticity, for example carbon fibers or titanium wires, are arranged relative to one another such that the desired braking effect upon introduction by internal friction between the fibers a tensile force is caused.
  • the connecting element as a woven, knitted, knitted or braided - -
  • elastic fibers such as aramid fibers or super-elastic wires made of nickel-titanium alloys.
  • the connecting element can also be produced in one piece from an elastic material. This allows a one-piece design of the connecting element in the manner of a round cord or a block, which is preferably provided with a profile determined by recesses, in order to ensure a high elasticity.
  • fluoroelastomers in particular perfluororubber, tetrafluoroethylene / propylene rubbers and fluorinated silicone rubber can be used.
  • the connecting element is connected to two insertion elements, which can be inserted into receiving shafts, which are formed on the two prosthesis plates.
  • the limiting device comprises braking surfaces, which are aligned such that upon rotation of a prosthesis plate about the axis of rotation, a braking surface, which is fixed to one of the two prosthesis plates, slides on a corresponding braking surface, which is fixed to the other prosthesis plate , wherein the frictional resistance between the braking surfaces increases as a result of the pressure exerted by the vertebral bodies with increasing angle of rotation.
  • the braking surfaces are preferably spaced from one another in such a way that a side inclination (lateral flexion) in a predetermined swivel angle range is possible.
  • Brake surfaces designed such that increases with increasing rotational angle of the distance between the prosthesis plates. With an increase in the distance of the prosthesis plates, the bandage around the spinal column is stretched and leads to an additional increase in the pressure exerted by the vertebral bodies. This also increases the frictional resistance between the braking surfaces. Taking advantage of the anatomical conditions of the patient, a rotation counteracting deceleration is achieved in this way, the vigorous, but always increases continuously with increasing angle of rotation and thereby avoids short-term load peaks, such as arise in undamped attacks.
  • the braking surfaces can be aligned such that the braking surface slides on a prosthesis plate on the corresponding braking surface on the other prosthesis plate only after exceeding a predetermined angle of rotation. In this case, the braking effect thus occurs only from a certain angle of rotation.
  • This behavior corresponds to that of the natural intervertebral disc prosthesis, since even there, with a small angle of rotation, the intervertebral disc has only a very low resistance to the rotation.
  • the limiting device comprises at least two opposing Prothe senplatten associated stop surfaces for limiting the rotation angle. This allows a particularly simple construction of the intervertebral disc prosthesis can be realized.
  • the limiting device is set up for the provision of a rotational angle-dependent braking force in a rotational angle range which is at least 10 percent, preferably at least 20 percent, of a predefinable maximum rotational angle of the prosthesis plates.
  • the maximum turning angle is structurally determined by the design of the intervertebral disc prosthesis.
  • the maximum rotation angle is the angle which is swept by rotation of the implanted prosthesis plates from a neutral position in one of the two directions of rotation until it comes to a complete deceleration of the rotational movement between the prosthesis plates by the braking force or the braking torque.
  • the limiting device according to the invention provides the braking force or the braking torque in addition to an already caused by friction between the articular surfaces of the prosthesis plates friction force. According to the invention, provision of the braking force takes place when the angle of rotation between the prosthesis plates has reached a value which corresponds to at least 90 percent, preferably at least 80 percent, of the maximum rotational angle.
  • the limiting device is set up such that the maximum angle of rotation and / or the - -
  • a pivoting of the prosthesis plates takes place about pivot axes of the pivot bearing, which lie at least almost in the plane of rotation of the rotary movement. Pivoting movements of the prosthetic plates occur during flexion, extension and lateral flexion of the spine. With a pivoting movement of the prosthesis plates about at least one pivot axis, there is already an expansion of the ligaments, muscles and nerves surrounding the spinal column. If the pivoting movement is superimposed by a rotational movement, then a further stretching of the ligaments, muscles and nerves takes place.
  • intervertebral disc prosthesis reflects the behavior of the natural disc, in which the torsional stresses are superimposed by the rotation of the vertebral bodies and interposed intervertebral disc caused by the pivotal compressive stresses in the disc and thus lead to increased resistance to movement.
  • FIG. 1 shows a plan view of a prosthesis plate with exchangeable stop elements and an exchangeable joint depression
  • FIG. 2 shows a side view of the prosthesis plate according to FIG. 1,
  • FIG. 3 shows a plan view of a prosthesis plate with exchangeable stop elements and an exchangeable joint ball
  • FIG. 4 shows a side view of the prosthesis plate according to FIG. 3,
  • FIG. 5 shows a disc prosthesis formed from the prosthesis plates according to FIGS. 1 and 3,
  • FIG. 6 shows a plan view of a prosthesis plate with exchangeable stop elements and an exchangeable ball joint, which has two stop projections,
  • FIG. 7 is a sectional view of the prosthesis plate according to FIG. 6,
  • FIG. 8 shows a top view of a prosthesis plate with exchangeable stop elements and an exchangeable joint depression provided with movement spaces for stop projections
  • FIG. 9 shows a sectional view of the prosthesis plate according to FIG. 8, FIG.
  • FIG. 10 shows a disc prosthesis formed from the prosthesis plates according to FIGS. 6 and 8, - -
  • FIG. 11 shows a plan view of a prosthesis plate with an exchangeable articulated recess, which is provided with a resilient blocking web
  • FIG. 12 a sectional view of the prosthesis plate according to FIG. 11,
  • FIG. 13 shows a plan view of a prosthesis plate with an exchangeable ball joint, which is provided with a movement groove
  • FIG. 14 a sectional view of the prosthesis plate according to FIG. 13,
  • FIG. 15 shows a disc prosthesis with flexible connecting elements which are attached to insertion elements for the prosthesis plates
  • FIG. 16 shows an intervertebral disc prosthesis with a connecting element mounted between the prosthesis plates on insertion elements.
  • Disc prostheses each comprise prosthesis plates 10, which are made of a metallic material and have a kidney-shaped outer contour.
  • An outer surface 12 of the prosthesis plates 10 is for abutment against a vertebral body, not shown, and is provided with a curvature 16, which is inserted into a bone made of stronger bone material. formed ring of the vertebral body engages.
  • An inner surface 14 of the prosthesis plates 10 has three shafts 18, 20, 22, which are adapted to receive insertion elements.
  • Other embodiments of prosthesis plates can also be used for realizing the features according to the invention.
  • insertion elements 23 provided with brake pins 24 are received in the shafts 18 and 22.
  • insertion elements 25 provided with brake ramps 26 are received in the shafts 18 and 22.
  • a hinge plate 28 is received in the shaft 20, which is provided with a concave-shaped, spherical cap-shaped joint recess 30.
  • the joint cavity 30 forms with the arranged in the prosthetic plate 10 according to Figures 1 and 2 joint ball 32 in Figure 5 in more detail shown ball joint 34.
  • the ball joint 34 allows rotational movement of the prosthesis plates 10 to the neutral position shown in the illustrated normal to the outer surfaces 12 of Prostheses plates 10 aligned axis of rotation 36 and pivotal movements of the prosthesis plates 10 about pivot axes 42 and 44, as shown by way of example in Figures 1 and 3.
  • the pivot axes 42 and 44 are in the neutral position of the disc prosthesis 40 shown in Figure 5 in a direction orthogonal to the axis of rotation 36 aligned plane.
  • the ball joint 34 allows a relative movement of the prosthesis plates 10 of the intervertebral disc prosthesis 40 with three rotatory degrees of freedom. - -
  • grooves 38 which have a rectangular cross-section and a determination of the insertion elements 23, 25 in the manner of a tongue and groove - enable connection.
  • the cross section of the groove 38 can be seen, for example, in FIG. Additional measures for determining the insertion elements 23, 25 may be in a suitable material selection to achieve a high friction between the insertion element and the prosthesis plate 10.
  • fasteners not shown, such as screws can also be used to reliably fix the insertion elements 23, 25 to the prosthesis plates 10.
  • a pivoting angle limit for pivoting movements of the prosthesis plates 10 is already ensured by the outer shape, the inner surfaces 14 approaching partially when performing a pivoting movement and come to rest, so that a further pivoting of the prosthesis plates 10 is prevented relative to each other.
  • To limit the rotational movement therefore serve the equipped with brake pin 24 and brake ramps 26 slide-in elements 23, 25.
  • the brake pin 24 has the front side on a spherical cap shape.
  • the braking ramp 26 is designed as a curved web with a concave, trough-like depression 48. The depth T of the recess 48 and the size of the brake pin 24 are selected such that in the neutral position - -
  • the brake pins 24 come into abutment with the braking ramps 26 and, with continued rotational movement, slide onto the regions of the braking ramp 26 which increase with increasing pitch. Due to the axisymmetric design and arrangement of the brake pins 24 and the brake ramps 26 relative to the pivot axis 42, undesired tilting of the prosthesis plates 10 is avoided. Due to the pressure forces that are introduced by the vertebral bodies on the outer surfaces of the prosthesis plates 10, occur by the sliding of the brake pin 24 on the brake ramps 26 with increasing rotational angle steadily increasing friction forces, which lead to a deceleration of the rotational movement. With reference to the axis of rotation 36, the frictional forces produce a braking moment which is introduced via the prosthesis plates 10 onto the vertebral bodies and which is opposite to the torque introduced by the ligament apparatus or by external forces.
  • the spinal column apparatus additionally tensioned, whereby the pressure forces on the prosthesis plates 10 and the resulting frictional forces increase.
  • the braking torque caused by the friction forces increases with increasing rotation angle.
  • the insertion elements 123, 125 are provided with parallelepiped stops 126 which serve to limit a pivoting movement (lateral flection) about the pivot axis 42.
  • 132 two projections 150 are attached to the joint ball, which are formed kugelkalottenförmig.
  • corresponding control grooves 152 are provided to the projections 150, which serve the rotation angle limit.
  • the control recesses 152 are formed as curved recesses in the joint depression 130 and thus permit both a limitation of a pivoting movement and a limitation of a rotational movement of the prosthesis plates 10.
  • control recesses 152 are designed such that a relative position Pivoting the prosthesis plates 10 around the pivot axis 44 is not limited.
  • relative pivoting of the prosthesis plates 10 about the pivot axis 42 is limited even without the parallelepiped stops 126 illustrated in FIGS. 6 and 8 due to the rising of the control wells 152 all the way to the surface of the joint depression 130.
  • the rotational movement of the prosthesis plates 10 relative to one another is likewise limited by the rise of the control depressions 152 as far as the surface of the joint depression 130.
  • the design of the contour of the projections 150 and / or the control recesses 152 can influence the characteristic of the angle of rotation limitation and possibly the characteristic of the swivel angle limitation. To influence these characteristics, the size of the projections 150 and / or the extent of the control wells 152 and their curvature can be varied.
  • the inner surfaces 262 of the slot 256 when exceeding a predetermined by the dimensioning of the web 254 and the slot 256 rotation angle in abutment against the outer surfaces 260 of the web 254. In this case takes place a force transmission between the inner surfaces 262 and the outer surfaces 260, which to a Deformation of the elastic web 254 leads. As a result, a restoring force is exerted on the inner surfaces 262, which causes a braking torque on the prosthesis plate 10.
  • the restoring force depends not only on the dimensioning of the web 254 but also on its material properties, in particular on its modulus of elasticity.
  • the insertion elements 323, 325 are provided with pliable tissue tube sections 364, which are made of titanium fibers and whose length is dimensioned such that no swivel angle limitation occurs even with superimposed pivoting about both pivot axes 42, 44 , If, on the other hand, a rotational movement of the prosthesis plates 10 takes place relative to one another, the angle of rotation is limited by the length of the fabric tube sections 364.
  • the elasticity properties of the fabric tube sections 364 allow a gentle deceleration of a rotational movement, they can be adjusted by suitable selection of the aramid fibers.
  • a limiting element 466 is attached to the opposing insertion elements 468, - -
  • the limiting element 466 which is made of an implantable elastomer, in particular of a fluoroelastomer.
  • the limiting element 466 has a high degree of flexibility for pivoting movements about the pivot axes 42 and 44 and is thereby exposed to pressure loads.
  • the limiting element 466 serves for pivoting movements about the pivot axes 42, 44 in each case as an elastic stop. With a relative rotation of the opposing prosthesis plates 10, the limiting element 466 is subjected to tensile loads and limits the angle of rotation for the prosthesis plates 10 by virtue of its elasticity.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Jeu de pièces destinées à la construction d'une prothèse de disque intervertébral destinée à être placée dans un espace intervertébral délimité par des corps vertébraux, qui comporte deux plaques de prothèse (10) placées mobiles l'une par rapport à l'autre, dont les surfaces externes (12) sont destinées à venir s'appuyer sur des surfaces de corps vertébraux opposés et dont les surfaces internes (14) forment, après assemblage, des surfaces correspondantes d'un palier de pivotement (34; 134; 334; 434). Selon l'invention, ledit ensemble de pièces comporte en outre un dispositif de limitation (24, 26; 150, 152; 254, 256; 364; 466) associé au palier de pivotement (34; 134; 334; 434) et destiné à limiter un mouvement de rotation autour d'un axe de rotation (36) pratiquement perpendiculaire aux surfaces externes (12) des plaques de prothèse (10). Ledit dispositif de limitation peut être relié aux plaques de prothèse (10).
PCT/EP2009/006906 2008-09-24 2009-09-24 Jeu de pièces pour la construction d'une prothèse de disque intervertébral et système de construction de différentes prothèses de disques intervertébraux WO2010034496A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP09740261.4A EP2339993B1 (fr) 2008-09-24 2009-09-24 Jeu de pièces pour la construction d'une prothèse de disque intervertébral et système de construction de différentes prothèses de disques intervertébraux
US13/120,584 US20110257747A1 (en) 2008-09-24 2009-09-24 Kit for constructing a spinal disk prosthesis, and system for constructing different spinal disk prostheses
CN2009801454831A CN102215786A (zh) 2008-09-24 2009-09-24 用于构造椎间盘假体的套件以及用于构造不同的椎间盘假体的系统

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102008048739.2 2008-09-24
DE102008048739A DE102008048739A1 (de) 2008-09-24 2008-09-24 Bandscheibenprothese

Publications (1)

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WO2010034496A1 true WO2010034496A1 (fr) 2010-04-01

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PCT/EP2009/006906 WO2010034496A1 (fr) 2008-09-24 2009-09-24 Jeu de pièces pour la construction d'une prothèse de disque intervertébral et système de construction de différentes prothèses de disques intervertébraux

Country Status (5)

Country Link
US (1) US20110257747A1 (fr)
EP (1) EP2339993B1 (fr)
CN (1) CN102215786A (fr)
DE (1) DE102008048739A1 (fr)
WO (1) WO2010034496A1 (fr)

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DE102012004705A1 (de) 2012-03-07 2013-09-12 Franz Copf Verfahren zur computergestützten Bestimmung der Lage eines auf einem Röntgenbild abgebildeten Wirbelsäulenabschnitts relativ zu einem Röntgengerät
US9198770B2 (en) 2013-07-31 2015-12-01 Globus Medical, Inc. Artificial disc devices and related methods of use
CN108969159B (zh) * 2018-07-27 2021-03-19 深圳清华大学研究院 椎间运动保留装置
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CN102215786A (zh) 2011-10-12
EP2339993B1 (fr) 2014-08-27
US20110257747A1 (en) 2011-10-20
DE102008048739A1 (de) 2010-04-01
EP2339993A1 (fr) 2011-07-06

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